Protease Injury in the Development of COPD*

these last two presentations, one could conclude that the role of nutritional support, exercise, and anabolic agents needs to be evaluated in larger controlled clinical trials. The role of corticosteroids, which remains the only widely used anti-inflammatory drug used in the therapy of COPD, was reviewed in detail. The conclusions were fairly straight forward, namely that systemic corticosteroids appear to have a modest effect on decreasing the length of exacerbations in hospitalized patients, but clearly do not improve long-term outcome. Hence, long-term steroid use was not supported. Inhaled corticosteroids have recently been tested in several large multicenter studies that have shown a modest decrease in the number and duration of exacerbations, but do not prevent the decline in airway function. The take-home message for clinicians is that, while there is no immediate new effective wonder drug available to us, the future looks brighter and more exciting since more research is being done than ever before. It is our hope that these new interventions will be successful and available to our patients in the future.